Age at First Alcohol Intoxication: Association With Alcohol, Tobacco, Cannabis and Other Substance Use Among 19 Year-Old Swiss Young Men

Title of the conference

The Art and Science of Generalist Care, 32nd Annual Meeting of the Society of General Internal Medicine

Author(s)

BertholetN., GaumeJ., FaouziM., GmelG., DaeppenJ.

Address

Miami Beach, Florida, May 13-16, 2009

Publication state

Published

Issued date

2009

Volume

24

Series

Journal of General Internal Medicine

Pages

S17

Language

english

Notes

BACKGROUND: Alcohol use, alcohol intoxication, tobacco, cannabisand other drug use are frequent among young Swiss men. Theassociation between age at first alcohol intoxication and other substanceuse is of interest from both clinical and public health perspectives.METHODS: A census of Swiss francophone 19 year-old men consecutivelyreporting for processing at the army recruitment in Lausanne,Switzerland were assessed via a self-report survey that included:number of drinks (i.e., 10 g ethanol each) and number of drinkingoccasions with six or more drinks over the past 12 months; age at firstalcohol intoxication; current tobacco and cannabis use; and lifetime useof other (illegal) substances, including prescription drug abuse. Weeklyrisky drinking was defined as >21 drinks per week and risky singleoccasion drinking (RSOD) as 6 or more drinks per occasion. Associationsbetween age at first intoxication and current weekly riskydrinking, RSOD, current tobacco and cannabis use, and lifetime useof other drugs were determined through logistic regression models.Poisson regressions that allowed for over-dispersion were used to modelnumber of standard drinks per week and RSOD episodes per month atage 19, based on age at first intoxication.RESULTS: Of the 12,133 young men presenting for the mandatoryarmy recruitment procedures, 9,686 (80%) completed the survey. Ofthese, 8,687 (90%) reported at least one episode of alcohol intoxication,with a median age (Interquartile range [IQR]) at first intoxication of15 years (14, 16), 6 (1, 16) drinks/week, and 2 (0, 4) RSOD episodes ofbinge drinking/month. Prevalence of current tobacco and cannabis usewas 50.2% and 44.6% respectively. Lifetime use of other drugs was17.2%. Odds ratio (95% CI) for subjects with a first alcohol intoxicationbefore the age of 15 showed they were more likely than subjects with afirst intoxication at age 15 or older to present weekly risky drinking [3.2(2.8, 3.6)], RSOD [2.3 (2.1, 2.6)], current tobacco [2.6 (2.4, 2.8)],cannabis use [2.7 (2.5, 3.0)], and lifetime use of other drugs [3.5 (3.1,3.9)]. For each age from 13 to 19 years, the occurrence of firstintoxication was associated with a 15.6% (95% CI 14.6, 16.6) increasein the number of drinks per week and a 14.7% (13.7, 15.6) increase inthe number of RSOD episodes per month.CONCLUSION: Among 19 year-old Swiss men, the prevalence of alcoholintoxication is elevated, with the age at first intoxication for half of thembeing less than 15 years. Since early alcohol intoxication is associatednot only with heavier alcohol use at age 19 but also with increased riskof tobacco, cannabis and other drug use, physicians should considerage at first intoxication both as a potential target for counseling and asa potential indicator of later alcohol and other substance use.